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Infrequent Urination
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Infrequent Urination


I am 22 year old, uncircumcised male.  4 Months ago I had unprotected sex with someone who is now my girlfriend.  Both of us have had less than 3 sexual partners.  About 3 weeks after sex, I noticed that I could only pass a small amount of urine and had a constant desire to pee.  I went to a clinic where I was tested for Chlamydia and Ghonorea (Gonorrhea), both were negative.  I was treated with Doxycycline and the problem immediately went away.  My girlfriend showed no symptoms.  About 3 weeks later the problem came back, tests were negative again (this time including Herpes because I had slight redness which was later attributed to a mild yeast infection) again I was treated with Doxycycline and again the symptoms immediately went away.  

About 2 weeks later I had significantly lost the desire to urinate and this time i had some scrotal tightness.  I went to a Urologist and he examined my prostate which seemed normal and they did a urine flow test.  THE MAIN ISSUE is that I can drink large amounts of fluids and I never have a strong urge to urinate.  When I do it is not as much fluid as before and I don't feel like I have as much muscle control over starting and stopping urination.  When I did the urine flow test, I emptied something like 250 cc's of fluid but left 50 cc's in my bladder.  The urologist said if I came back he would consider using a scope inside the urethra.  He gave me doxycycline because it had worked in the past, however, it did not relieve the symptoms this time (although I wasn't that surprised because recall that the symptoms have changed since the first incident).  

I am very mystified by the fact that I can drink a lot of water and I never really have to go pee.  Everything would otherwise be normal if I didn't have the feeling that I should be peeing more when I am not.  I drink what I feel is a normal amount of water each day.  Everything else I have read about urinary issues describes problems of small amounts of urination but with the constant urge to urinate and that is the certainly not what I have.   My girlfriend went to her Gynocologist and a full test revealed nothing.  Is it likely to have scar tissue or some sort of blockage that would cause these symptoms?  I have never had extreme pain or blood in my urine.  Or is it possible that I should try an antibiotic other than doxycycline.  I am hesitant to take more antibiotics because I have already taken them 3 times in the last 4 months.  

The only other thing is that I feel like my erections are not as strong as they were before all of this stuff happened.  I am not sure if it is related or simply just because I have a certain amount of anxiety about the whole situation.  

Thanks for your help, sorry for the long explanation.
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Ensure there is no kidney disease should be a priority.  Blood tests to evaluate the kidney function can be considered.

I would also consider prostatitis - which can lead to some of the urinary symptoms.  A digital rectal exam to evaluate the prostate for infection, and/or a transrectal ultrasound, can be considered.  Many cases of prostate infection requires long courses - sometimes months - of antibiotics.

If these tests are negative, I would agree with the cystoscopy your urologist is suggesting.  This can rule out anatomical abnormalities such as a urethral stricture or urethral polyp.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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